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Home My WebLink AboutWA-27553_38701_C_NRP_20190701An Equal Opportunity Employer July 1, 2019 CERTIFIED MAIL Ms. Anna Edwards North Carolina Department of Environmental Quality 943 Washington Square Mall Washington, North Carolina 27889 RE: Notice of Residual Petroleum and No Further Action Package Speedway #8680 883 US Highway 64 East Columbia, North Carolina Tyrrell County Incident No. 38701 GRI Project # 4075 Ms. Edwards: GRI presents the attached certified Notice of Residual Petroleum, Public Notice Letters and monitoring well abandonment record to complete the NRP/NFA activities at the above mentioned site. Please let me know if you have any questions. Sincerely, Speedway, LLC. Chuck Chiara Environmental Representative Enclosure Speedway LLC Speedway Office P.O. Box 1500 Springfield, OH 45501 Telephone 937-864-3000 6/27/2019 USPS.com® - USPS Tracking® Results https://tools.usps.com/go/TrackConfirmAction?tRef=fullpage&tLc=9&text28777=&tLabels=70181830000222996875%2C70181830000222996882%2C…1/5 USPS Tracking FAQs  (https://www.usps.com/faqs/uspstracking-faqs.htm)® Track Another Package + See Less  Tracking Number: 70181830000222996875 Your item was delivered at 10:20 am on June 17, 2019 in COLUMBIA, NC 27925. Delivered June 17, 2019 at 10:20 am Delivered COLUMBIA, NC 27925 Get Updates  Text & Email Updates  Tracking History  Product Information  Tracking Number: 70181830000222996882 Your item was delivered at 10:20 am on June 17, 2019 in COLUMBIA, NC 27925. 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Delivery Attempt: Action Needed Reminder to Schedule Redelivery of your item before July 1, 2019 Schedule Redelivery  See More  Tracking Number: 70181830000222996905 Your item was delivered at 3:22 pm on June 20, 2019 in COLUMBIA, NC 27925. Delivered June 20, 2019 at 3:22 pm Delivered COLUMBIA, NC 27925 Get Updates  Remove  Remove Feedback 6/27/2019 USPS.com® - USPS Tracking® Results https://tools.usps.com/go/TrackConfirmAction?tRef=fullpage&tLc=9&text28777=&tLabels=70181830000222996875%2C70181830000222996882%2C…4/5 See Less  Tracking Number: 70181830000222996929 Your item was delivered to an individual at the address at 11:54 am on June 17, 2019 in WILLIAMSTON, NC 27892. Delivered June 17, 2019 at 11:54 am Delivered, Left with Individual WILLIAMSTON, NC 27892 Get Updates  Text & Email Updates  Tracking History  Product Information  Can’t find what you’re looking for? Go to our FAQs section to find answers to your tracking questions. FAQs (https://www.usps.com/faqs/uspstracking-faqs.htm) Remove Feedback 6/27/2019 USPS.com® - USPS Tracking® Results https://tools.usps.com/go/TrackConfirmAction?tRef=fullpage&tLc=9&text28777=&tLabels=70181830000222996875%2C70181830000222996882%2C…5/5 The easiest tracking number is the one you don't have to know. With Informed Delivery , you never have to type in another tracking number. Sign up to: See images* of incoming mail. Automatically track the packages you're expecting. Set up email and text alerts so you don't need to enter tracking numbers. Enter USPS Delivery Instructions for your mail carrier. Sign Up (https://reg.usps.com/entreg/RegistrationAction_input? app=UspsTools&appURL=https%3A%2F%2Ftools.usps.com%2Fgo*NOTE: Black and white (grayscale) images show the outside, front of letter-sized envelopes and mailpieces that are processed through USPS automated equipment. ® ™Feedback WELL ABANDONMENT RECORD Form GW-30 North Carolina Department of Environmental Quality - Division of Water Resources Revised 2-22-2016 1.Well Contractor Information: Well Contractor Name (or well owner personally abandoning well on his/her property) NC Well Contractor Certification Number Company Name 2.Well Construction Permit #: List all applicable well construction permits (i.e. UIC, County, State, Variance, etc.) if known 3.Well use (check well use): Water Supply Well: □Agricultural □Municipal/Public □Geothermal (Heating/Cooling Supply)□Residential Water Supply (single) □Industrial/Commercial □Residential Water Supply (shared) □Irrigation Non-Water Supply Well: □Monitoring □Recovery Injection Well: □Aquifer Recharge □Groundwater Remediation □Aquifer Storage and Recovery □Salinity Barrier □Aquifer Test □Stormwater Drainage □Experimental Technology □Subsidence Control □Geothermal (Closed Loop)□Tracer □Geothermal (Heating/Cooling Return) □Other (explain under 7g) 4. Date well(s) abandoned: 5a. Well location: Facility/Owner Name Facility ID# (if applicable) Physical Address, City, and Zip County Parcel Identification No. (PIN) 5b. Latitude and longitude in degrees/minutes/seconds or decimal degrees: (if well field, one lat/long is sufficient) N W CONSTRUCTION DETAILS OF WELL(S) BEING ABANDONED Attach well construction record(s) if available. For multiple injection or non-water supply wells ONLY with the same construction/abandonment, you can submit one form. 6a. Well ID#: 6b. Total well depth: (ft.) 6c. Borehole diameter: (in.) 6d. Water level below ground surface: (ft.) 6e. Outer casing length (if known): (ft.) 6f. Inner casing/tubing length (if known): (ft.) 6g. Screen length (if known): (ft.) WELL ABANDONMENT DETAILS 7a. For Geoprobe/DPT or Closed-Loop Geothermal Wells having the same well construction/depth, only 1 GW-30 is needed. Indicate TOTAL NUMBER of wells abandoned: 7b. Approximate volume of water remaining in well(s): (gal.) FOR WATER SUPPLY WELLS ONLY: 7c. Type of disinfectant used: 7d. Amount of disinfectant used: 7e. Sealing materials used (check all that apply): □Neat Cement Grout □Bentonite Chips or Pellets □Sand Cement Grout □Dry Clay □Concrete Grout □Drill Cuttings □Specialty Grout □Gravel □Bentonite Slurry □Other (explain under 7g) 7f. For each material selected above, provide amount of materials used: 7g. Provide a brief description of the abandonment procedure: 8.Certification: Signature of Certified Well Contractor or Well Owner Date By signing this form, I hereby certify that the well(s) was (were) abandoned in accordance with 15A NCAC 02C .0100 or 2C .0200 Well Construction Standards and that a copy of this record has been provided to the well owner. 9.Site diagram or additional well details: You may use the back of this page to provide additional well site details or well abandonment details. You may also attach additional pages if necessary. SUBMITTAL INSTRUCTIONS 10a. For All Wells: Submit this form within 30 days of completion of well abandonment to the following: Division of Water Resources, Information Processing Unit, 1617 Mail Service Center, Raleigh, NC 27699-1617 10b. For Injection Wells: In addition to sending the form to the address in 10a above, also submit one copy of this form within 30 days of completion of well abandonment to the following: Division of Water Resources, Underground Injection Control Program, 1636 Mail Service Center, Raleigh, NC 27699-1636 10c. For Water Supply & Injection Wells: In addition to sending the form to the address(es) above, also submit one copy of this form within 30 days of completion of well abandonment to the county health department of the county where abandoned. For Internal Use ONLY: